Claims Policy And Procedures Specialist

Job Responsibilities and Requirements

KEY RESPONSIBILITIES

• other duties as assigned*

The Policy and Procedures Specialist is responsible for the creation, implementation and maintenance of all policy and procedure material for the Group Claims Operations. This role is responsible for ensuring operational excellence and collaborates with other members of the Claims Leadership team to improve operations beyond their role. In addition, this role will lead all change management and training activities related to Policy and Procedure changes as appropriate. Specifically:

• Create, manage, and maintain the claims policy and procedure online manual as well as the content on the claims intranet site.

• Research, determine and share industry standards on key disability and leave topics for all RSL Group Insurance products.

• Suggest updates to policy language as necessary and participate in the development of new products as appropriate.

• Collaborate with the Claims Leadership Team to determine policy and procedure standards

• Manage the implementation of all policy and procedure changes including communication and training activities.

• Partner with the Claims Leadership Team to ensure that workflows, procedures, and best practices are followed.

• Partner with Compliance team to ensure adherence to all regulatory process related requirements.

• Develops model and maintain effective working relationships with internal contacts in Sales, Service, Underwriting, Finance, Contracts and other teams as appropriate.

• Prioritize and track all policy and procedure topic requests along with any associated issues/areas of concern.

• Participate in large claims related initiatives requiring policy and/or procedure changes.

• Facilitate a weekly Subject Matter Expert Call for selected claims team members to solicit feedback on policy and procedure related topics.

• Provide guidance and direction on claims presenting complex and unusual issues

• Conduct targeted audits to understand impact of claims processes as needed

• Interacts directly with external and internal auditors to discuss and resolve technical claims related issues in a timely manner as appropriate

• Tracks and reports monthly operations activities to Claims Leadership team

REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE

• or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*

• High School Diploma required; Associates preferred; Bachelor's Degree desired.

• 5 - 7 years integrated disability and absence management claims industry experience required.

• In depth demonstrated knowledge of disability (short term, statutory and long term programs and funding; self-insured and fully insured) family medical leave and employer leave of absence programs.

• In depth knowledge of claim intake and operating systems and policy/plan programming preferred.

• Excellent written and verbal skills - able to listen and respond with professionalism and empathy, maintaining tact and diplomacy in stressful situations.

• Demonstrated ability to provide coaching, development and mentoring to employees.

• Demonstrated ability to utilize critical thinking and analytical skills with a passion for problem solving and resolution

• Demonstrated ability to communicate information to different audiences in a variety of mediums

• Demonstrated ability to establish strong relationships with stakeholders of various levels

• Demonstrated ability to execute on strategy

• Disciplined organizational skills with the ability to multi-task, organize, prioritize and meet deadlines across multiple projects

Ability to Travel: Up to 10%

PHYSICAL REQUIREMENTS

When used in the description below, the following terms are defined as:

"Occasional": done only from time to time, but necessary when it is performed

"Frequent": regularly performed; generally an act that is required on a daily basis

"Continuous": typically performed for the majority of an employee's shift

Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs., extensive typing, picking up and holding small objects, and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law.

CORE VALUES

• Collaboration

• Compassion

• Empowerment

• Integrity

• Fun

The above description reflects the general details considered necessary to describe the principal responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job.

Hiring Range: $84,870.00 - $113,300.00 Salary

• The hiring range listed in this posting represents the expected hiring range for work performed in the primary location (Hawthorne, NY). If this role is eligible for remote work, or will report to a different office than the one listed above, the hiring range may differ.

Work location may be flexible if approved by the Company.

What We Offer

At Reliance Matrix, we believe that creating a more diverse, equitable and inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you.

That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.

Our Benefits:

• An annual performance bonus for all team members

• Generous 401(k) company match that is immediately vested

• A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account

• Multiple options for dental and vision coverage

• Company provided Life & Disability Insurance to ensure financial protection when you need it most

• Family friendly benefits including Paid Parental Leave & Adoption Assistance

• Hybrid work arrangements for eligible roles

• Tuition Reimbursement and Continuing Professional Education

• Paid Time Off, volunteer days, community partnerships, and Employee Assistance Program

• Ability to connect with colleagues around the country through our Employee Resource Group program and our Diversity Equity & Inclusion Council

Our Values:

• Integrity

• Empowerment

• Compassion

• Collaboration

• Fun

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.

#LI-Hybrid .